Customs Export Declaration

CUSTOMS EXPORT DECLARATION AND EXPORT COMPLIANCE AGREEMENT

Parties and Declaration Reference

Exporter Name:

Consignee/Buyer Name:

Declaration Number:    Export Date:

Corporation    Individual    Partnership

WHEREAS

WHEREAS, Exporter Name: is the owner or authorized exporter of the goods described in this declaration; and

WHEREAS, the parties desire to document the export declaration, confirm compliance with applicable export control laws and customs requirements, and define the obligations of Exporter and the Export Agent/Carrier in respect of documentation, clearance and remittance of duties and fees;

WHEREAS, the Export Agent/Carrier named below will act on behalf of the exporter to prepare and submit customs documentation required to effect export clearance under the terms set forth in this agreement.

Export Agent / Carrier

Scope of Work

The Export Agent/Carrier shall perform the following services on behalf of the Exporter, which services shall include preparation, submission and follow up of all export documentation required by customs authorities and export control agencies, and arranging transport as specified:

Goods Description and Export Details

Port of Loading:    Port of Discharge:

Payment Terms

Total Fees Payable to Agent:

Payment Schedule:

Late Payment Fee:

Term and Termination

Agreement Start Date:    Agreement End Date:

Either party may terminate this agreement for convenience upon written notice delivered not less than days to the other party. Termination for material breach is permitted where the breaching party fails to cure within 15 days after written notice.

Export Controls, Certification and Liability

The Exporter certifies that the information contained in this declaration and any accompanying documentation is complete and accurate to the best of its knowledge, that the goods are not subject to prohibited end-uses, and that all required export licenses or authorizations have been obtained prior to shipment. The Exporter further agrees to indemnify and hold harmless the Agent/Carrier for liabilities, fines, penalties and legal costs arising from inaccurate or incomplete information supplied by the Exporter.

Are goods subject to export control or licensing requirements?   Yes    No

Confidentiality

Each party agrees that all non-public commercial, technical, and financial information exchanged in connection with this declaration and agreement shall be kept confidential and used only for the performance of this agreement, except as required by customs, export control authorities, or other competent governmental bodies. Confidential information may be disclosed to agents, carriers, and affiliates on a need-to-know basis provided such recipients are bound by confidentiality obligations no less protective than those herein.

Governing Law

This agreement and any dispute arising out of or relating to this agreement shall be governed by and construed in accordance with the laws of the jurisdiction where the Exporter is incorporated or domiciled, without regard to choice-of-law rules that would result in the application of the laws of another jurisdiction.

Entire Agreement

This document, together with any schedules, attachments and referenced declarations, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior negotiations, understandings, and agreements between the parties, whether written or oral. No modification shall be binding unless executed in writing and signed by duly authorized representatives of both parties.

Additional Declarations

Declarations and Penalties

The undersigned declares under penalty of law that the information set forth in this Customs Export Declaration and any accompanying documents is true, correct, and complete. The undersigned acknowledges that false statements may subject the declarant to civil and criminal penalties under applicable customs and export control laws.

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